Criteria for patient admission to an intensive care unit and related mortality rates.

OBJECTIVE

The aim of the study was to evaluate criteria used in clinical practice, for screening of patients for ICU admission.

METHODS

Cohort prospective study in a tertiary hospital. Four groups were compared in relation to ICU admission by ranking priorities into groups 1, 2, 3 and 4; highest priority 1, lowest priority 4.

RESULTS

Enrolled were 359 patients, 66 (53.2-75.0) years old. APACHE II was 23 (18-30). The ICU made available 70.4% of beds. Patients who were refused beds in the ICU were older, 66.2 ± 16.1 versus 61.9 ± 15.2 years of age (p= 0.02) and the priority 1 group had less refusal of beds, which means, 39.1% versus 23.8% had beds refused (p=0.01). The opposite occurred with priorities 3 and 4. Patients in priority 3 and 4 showed older ages, score system and more organ dysfunctions as well as more refusals of beds. ICU mortality rates were higher for priority groups 3 and 4 when compared to 1 and 2 priority groups, 86.7% versus 31.3% (p<0.001).

CONCLUSION

Age, score system and organ dysfunctions were greater in priority groups 3 and 4 and these were related with refusal from the ICU. Patients refused admission to the ICU showed higher mortality rates and these remained higher among priority groups 3 and 4 even when patients were admitted to the ICU.